Impacto do exame transoperatório de congelação nas tireoidectomias

Introdução: a indicação da congelação intra-operatória (CIP) em tireoidectomias é questão de debate no meio academico-médico. A utilização da CIP, sob justificativa de que poderia auxiliar no diagnóstico nos casos lesões malignas, e assim evitar reintervenções cirúrgicas, se mostra duvidoso. Objetivo: analisar a precisão e concordância entre a PAAF e a CIP e a influência da CIP na cirurgia de tireoide. Métodos: Foram avaliados retrospectivamente os dados de pacientes submetidos a tireoidectomias pelo serviço de Cirurgia Geral e Oncológica do Hospital de Clínicas de Porto Alegre no período de de janeiro de 2015 a dezembro de 2018. Foram analisados os dados da consulta pré-operatória, descrição cirúrgica, evoluções durante a internação, exames complementares e consultas pós operatórias. Foi utilizado o programa SPSS para a análise estatística sendo estabelecido o intervalo de confiança de 95% para a observação das diferenças entre as variáveis em estudo. Nas variáveis qualitativas foi calculado o percentual, e nas variáveis quantitativas médias e desvios-padrão respectivos. Resultados: a acurácia da CIP no diagnóstico das lesões tireoidianas mostrou sensibilidade de 74%, especificidade de 98,75, valor preditivo positivo de 96,1 e valor preditivo negativo de 89,6%. Os resultados com melhor acurácia foram encontrados nas categorias II, III e IV de Bethesda, quando estes são considerados com lesões benignas, na concordância com a CIP (acurácia= 95,5%) e AP (acurácia= 88,1%). Conclusão: a CIP tem baixa sensibilidade no diagnóstico de lesões malignas e sua indicação como ferramenta auxiliar no planejamento cirúrgico deve ser reconsiderada.Background: the indication of intraoperative freezing (CIP) in thyroidectomies is a matter of debate in the medical field. Used in many services, under the justification that the technique could assist in the diagnosis of malignant lesions and, thus, avoid surgical reinterventions, especially in cases where the diagnosis regarding the malignancy of the lesion is doubtful. In addition, it is known that a CIP presents good results in terms of specificity for malignancy, reaching 100% in most articles. It is also known that it has a high cost, increases the surgical time and denotes low diagnostic sensitivity. Aim: to determine accuracy and intertest agreement of PAAF and CIP findings in thyroid surgery, and to assess the influence of CIP findings on decision making and the utiity of CIP in thyroid surgery. Methods: all patients submitted to thyroidectomies were retrospectively evaluated by the General and Oncological Surgery service of Hospital de Clínicas de Porto Alegre (HCPA). The following was checked: the preoperative consultation, the surgical description, the evolution during the hospitalization, the complementary exams (including the definitive anatomopathological exam) and the postoperative consultations. The database was stored in the Excel program and the statistical analysis was converted for analysis by the SPSS program. A statistical analysis was performed using the same program, with 95% confidence intervals for observing the differences between the variables under study. Frequency tables were made available for all variables under study. In qualitative variables, it is possible to define the percentage, and in quantitative variables, means and standard deviations. Results: the assessment of the accuracy of the CIP in the diagnosis of thyroid lesions revealed a sensitivity of 74%, specificity of 98.75, a positive predictive value of 96.1 and a negative predictive value of 89.6%. The results with the best accuracy were found in Bethesda categories II, III and IV, when they are considered to have benign lesions, in agreement with the CIP (accuracy = 95.5%) and AP (accuracy = 88.1%). Conclusion: The results of the study demonstrate that IPC has low sensitivity in the diagnosis of malignant lesions and its indication as an auxiliary tool in surgical planning should be reconsidered

Contributos para o melhoramento em sobreiro: instalação de rebentos in vitro visando a obtenção de híbridos. Fenologia da espécie e ontogenia da sua reprodução sexuada

Mestrado em Engenharia Agronómica - Horticultura e Viticultura - Instituto Superior de AgronomiaFocusing cork-oak breeding, we assayed in vitro establishments of apical and nodal segments from mature trees of Quercus suber L. collected directly from the field, in order to reach a prompt method for controlled pollinations of female flowers established in vitro. The plant material used for in vitro establishment was sampled between April and September 2013 from a plot in south of Setúbal peninsula. In this context, phenology was monitored in a population of 31 trees from the same plot and the ontogenic development of reproductive female structures and acorns of one tree was histologically studied. The in vitro development of explants was very difficult, due to contaminations, tissue oxidation and low reactivity of explants, looking more promising the use of shoots in mouse-ear phenological stage (at the beginning of axis elongation) collected in spring, superficial sterilizations with solutions of calcium hypochlorite and fungicides and culture in agar water, with foliar fertilizer applications, prior being transferred to nutritive medium. Phenological data showed intraspecific variation and sporadic flowering, outside spring. Relationships between phenology and ontogeny were recognized, and a long progamic phase (80 days) and an early full differentiation of embryos have been documente

Intraoperative frozen section performance for thyroid cancer diagnosis

Objective: A primary medical relevance of thyroid nodules consists of excluding thyroid cancer, present in approximately 5% of all thyroid nodules. Fine-needle aspiration biopsy (FNAB) has a paramount role in distinguishing benign from malignant thyroid nodules due to its availability and diagnostic performance. Nevertheless, intraoperative frozen section (iFS) is still advocated as a valuable tool for surgery planning, especially for indeterminate nodules. Subjects and methods: To compare the FNAB and iFS performances in thyroid cancer diagnosis among nodules in Bethesda Categories (BC) I to VI. The performance of FNAB and iFS tests were calculated using final histopathology results as the gold standard. Results: In total, 316 patients were included in the analysis. Both FNAB and iFS data were available for 272 patients (86.1%). The overall malignancy rate was 30.4%% (n = 96). The FNAB sensitivity, specificity, and accuracy for benign (BC II) and malignant (BC V and VI) were 89.5%, 97.1%, and 94.1%, respectively. For all nodules evaluated, the iFS sensitivity, specificity, and accuracy were 80.9%, 100%, and 94.9%, respectively. For indeterminate nodules and follicular lesions (BC III and IV), the iFS sensitivity, specificity, and accuracy were 25%, 100%, and 88.7%, respectively. For BC I nodules, iFS had 95.2% of accuracy. Conclusion: Our results do not support routine iFS for indeterminate nodules or follicular neoplasms (BC III and IV) due to its low sensitivity. In these categories, iFS is not sufficiently accurate to guide the intraoperative management of thyroidectomies. iFS for BC I nodules could be an option and should be specifically investigated

Adjustment of the infiltration curve by different empirical models

A estimativa de algumas propriedades físico-hídricas do solo, por meio do uso de modelos empíricos, constitui uma excelente alternativa para a redução do tempo e do custo das análises laboratoriais, especialmente para aplicação rápida e precisa desses valores em projetos agrícolas. O objetivo do presente trabalho é estimar a velocidade de infiltração de água no solo por meio de modelos empíricos propostos por Horton, Kostiakov e Kostiakov-Lewis e comparar os resultados com os dados obtidos em campo por meio do infiltrômetro de anel. A pesquisa foi conduzida em solo de textura arenosa da área experimental da Empresa Estadual de Pesquisas Agropecuárias – EMEPA, localizada no município de Lagoa Seca (PB). Foram realizados, ao longo da área experimental, um total de 65 testes de infiltração, por meio do infiltrômetro de anel. Os modelos de Horton, Kostiakov e Kostiakov-Lewis foram ajustados aos dados obtidos em campo com o infiltrômetro de anel. Dentre os modelos testados, o proposto por Horton foi o que apresentou o melhor desempenho. Entretanto, os prognósticos dos modelos de Horton, Kostiakov e Kostiakov-Lewis foram praticamente similares.Conocer las estimativas de algunas propiedades físico hídricas del suelo, através del uso de modelos empíricos constituye una excelente alternativa de reducción de costos y de tiempo para los analisis laboratoriales, en especial pala la aplicación rápida y precisa de esos valores en projectos agrícolas. El objetivo de este trabajo es estimar la velocidad de la infiltración del agua en el suelo usando el méctodo empírico propuesto por Horton Kostiakov y Kostiakov-Lewis y cvomparar los resultados con los datos obtenidos a campo con el uso del infiltrómetro de anillo. La pesquisa se condujo en suelo de textura arenosa del área experimental de la Empresa Estadual de Pesquisas Agropecuárias –EMBRAPA, localizada en la Municipalidad de Lagoa Seca  en el Estado de Pernambuco.  Realizamos aproximadamente 65 experimentos de infiltración con el infiltrómetro de anillo. Los modelos propuestos por Horton Kostiakov y Kostiakov-Lewis fueron ajustados a los datos obtenidos a campo con el infiltrómetro de anillo. Entre todos los modelos testados el de Horton presentó los mejores resultados. Entretanto, los pronósticos de los modelos Horton Kostiakov y Kostiakov – Lewis se mostraron muy similares.The estimation of some hydro-physical properties of soil through the use of empirical models is an excellent alternative for reducing the time and cost of laboratory tests, especially for quick and precise application of those values in agricultural projects. The aim of this study is to estimate the speed of infiltration of water into the soil by means of empirical models proposed by Horton, Kostiakov and Kostiakov-Lewis and comparing the results with data obtained in the field through the ring infiltrometer. The research was conducted in sandy soil texture of the experimental area of the State Enterprise for Agricultural Research - EMEPA, located in Lagoa Seca, PB. A total of 65 tests of infiltration through the ring infiltrometer were performed along the experimental area. The models of Horton, Kostiakov and Kostiakov-Lewis, were fitted to data obtained in the field with the ring infiltrometer. Among the models tested, the one proposed by Horton had the best performance. However, the prognostic models of Horton, Kostiakov and Kostiakov-Lewis were almost similar

Para além da Educação a Distância: Práticas Formativas e Relacionais em um Curso de Ciências Biológicas

As práticas de formação que incentivam o desenvolvimento das habilidades afetivas em estudantes têm sido avaliadas no contexto de ensino a distância no Brasil. O estudo tem como objetivo apresentar práticas formativas e relacionais desenvolvidas no curso de Ciências Biológicas na modalidade a distância de uma universidade estadual no Ceará. É um estudo descritivo-reflexivo em forma de estudo de caso que discute experiências em andamento, sendo estas: Monitoria Acadêmica; Vida em Foco; Ciência na Escola e Musicalizando a Biologia. As atividades têm procurado desenvolver nos alunos o espírito de colaboração e da experiência de realidade em que, em um curto espaço de tempo, estarão inseridos. Acredita-se que, dessa forma, se permite um ensino mais crítico e reflexivo, no qual novas ferramentas são oportunizadas e que podem romper a hierarquia ainda persistente entre professores e alunos. Palavras-chave: Ensino; Atitude; Educação a distância; Educação superior; Tecnologia da educação.Beyond the Distance Education: Formation and Relational Practice in a Biological Sciences CourseAbstract Training practices that encourage the development of affective skills in students have been valued in the context of distance learning (DL) in Brazil. The study aims to provide formative and relational practices developed in the course of Biological Sciences in the distance mode of a state university in Ceara. It is descriptive-reflective research in the form of case study that discusses the following ongoing experiments: Academic Monitoring; Life in Focus; Science in School and Musicalizing Biology. The activities have sought to develop in students the spirit of collaboration and the experience of reality in which they, in a short time, will be placed. It is believed that  this way allows more critical and reflective teaching, in which new tools become available for DL that will break the persistent hierarchy between teachers and students.Keywords: Teaching; Attitude; Distance education; Higher education; Education technology

MORFOMETRIA CORPORAL, RENDIMENTO DE CORTES E COMPOSIÇÃO CENTESIMAL DO FILÉ DA PESCADA GÓ

The king weakfish Macrodon ancylodon is a marine species, Sciaenidae family, with economic importance due to the wide distribution and market acceptation. Thus, the aim of study was to evaluate body morphometric relationships, yield and centesimal composition of king weakfish fillet. Therefore, 60 fish were organized in four weight class (T1=100-200g, T2=201-300g, T3=301-400g e T4=401-500g). Body weights and measures were measured for subsequent analyzes of the morphometric relationships, the yields and the centesimal composition of the fillets. Results were submitted to Analysis of Variance (ANOVA) post hoc Tukey test (p<0.05). There is statistical difference on morphometric relationships with the better results for T3 and T4 fish class. Still, for T3 class was observed the largest fillet yield without skin (42.90%) and smallest skin yield (8.36%). The protein levels for all weight classes had an inversional value when compared to the lipid values, showing numbers above 19%. For these reasons, the king weakfish show excellent nutritional quality being fish above 300g has better yield and morphometric relationships.Keywords: Macrodon ancylodon; fillet cuts; fishing technology; nutritional value.A pescada gó (Macrodon ancylodon), é uma espécie marinha, da família Sciaenidae, economicamente importante, devido a sua ampla distribuição e grande aceitação no mercado. O objetivo do estudo foi avaliar as relações morfométricas corporais, os rendimentos de cortes e a composição centesimal do filé da pescada gó. 60 exemplares foram distribuídos em quatro classes de peso, (T1=100-200g, T2=201-300g, T3=301-400g e T4=401-500g). Pesos e medidas corporais foram aferidos para subsequentes análises das relações morfométricas, os rendimentos e composição centesimal dos filés. Os resultados foram submetidos à análise de variância (ANOVA) e teste Tukey (P<0,05). Houve diferenças significativas nas relações morfométricas, sendo os peixes das classes T3 e T4, apresentaram os melhores resultados. Em relação aos rendimentos dos cortes, os peixes da classe T3 foram os que demonstraram o maior rendimento de filé sem pele (42,90%) e o menor rendimento de pele (8,36%). O teor de proteína avaliado nos filés dos peixes das quatro classes de peso foi inversamente proporcional aos valores de lipídios, com valor superior a 19% de proteína bruta. Os resultados indicam que a pescada gó apresenta excelente qualidade nutricional e que peixes acima de 300g apresentam melhores relações morfométricas e rendimentos.Palavras-chave: Macrodon ancylodon, cortes de filé, tecnologia do pescado, valor nutricional

Enriched artemia nauplii with commercial probiotic in the larviculture of angelfish Pterophyllum scalare Lichtenstein (1823)

This study evaluated the effect of enriched artemia nauplii with commercial probiotic for angelfish larvae determining productive performance, intestinal modulation and survival. Therefore, it experiment occurred in completely randomized design with five treatments (T1- 0.0, T2- 1.5, T3- 3.0, T4- 4.5 and T5- 6.0g of commercial probiotic) and four replaces during 20 days. After larvaculture, post larvae passed by biometric procedures to determine productive performance and then microbiological analysis. Occurred reduction of total heterotrophic bacteria while increased lactic acid bacteria in the intestinal tract from the post larvae for treatments T3, T4 and T5. The commercial probiotic also increased the survival and performance as final weight, weight gain and specific growth rate. For these reasons, the use of 3g of commercial probiotic promotes greater performance and intestinal modulation for angelfish larvae

Autonomia Criativa em Educação a Distância: Uso do Flipsnack em um Curso de Ciências Biológicas

A aprendizagem autônoma é um dos fundamentos da educação a distância. Recursos tecnológicos importantes que permitem o desenvolvimento do poder de decisão e utilização de estratégias criativas devem ser estimulados para os alunos. Este é um estudo descritivo com abordagem qualitativa que descreve as experiências iniciais e as percepções de tutores sobre as dificuldades apresentadas pelos alunos com o uso de flipsnack, uma ferramenta que permite a criação e publicação de e-books, focando o desenvolvimento da criatividade e autonomia. Acredita-se que esta ferramenta vai contribuir para a formação acadêmica, oferecendo oportunidades para o desenvolvimento da autonomia criativa e seu papel fundamental na sua prática de ensino profissional.  Palavras-chave: Ensino; Educação a distância; Educação superior; Tecnologia da educação; Autonomia profissional. Creative Autonomy in Distance Education: Flipsnack Use in a Biological Sciences CourseAbstract Autonomous learning is one of the foundations of distance education (DE). Important technological features that allow the development of power of decision and the use of creative strategies must be stimulating for the students. This is a descriptive study with a qualitative approach that describes the initial experiences and tutors perceptions of difficulties presented by students with use of flipsnack, a tool that permits the creation and publication of e-books, which focuses on the development of creativity and autonomy. It is believed that this tool will contribute to academic training, providing opportunities for the development of creative autonomy and its fundamental role in their professional teaching practice.  Keywords: Teaching; Distance education; Higher education; Education Technology; Professional Autonomy

Esophagogastric junction outflow obstruction successfully treated with laparoscopic Heller myotomy and Dor fundoplication : first case report in the literature

BACKGROUND Esophagogastric junction outflow obstruction (EGJOO) is a rare syndrome, characterized by an elevation of the integrated relaxation pressure of the lower esophageal sphincter, not accompanied by alterations in esophageal motility that may lead to the criteria for achalasia. We were unable to find any prior report of the combination of Heller myotomy with anterior partial fundoplication (Dor) as the treatment for EGJOO. We herein report a case of EGJOO treated with laparoscopic Heller myotomy combined with Dor fundoplication. CASE SUMMARY A 26-year-old man presented with a 3-year history of solid dysphagia and a 30-kg weight loss. He was treated with oral nifedipine, isosorbide, and omeprazole, without resolution of symptoms. An upper gastrointestinal series (barium swallow) revealed a “bird’s beak” sign. Esophagogastroduodenoscopy was positive for Los Angeles grade A peptic esophagitis. High-resolution esophageal manometry was compatible with EGJOO. Esophageal pH monitoring showed pathological acid reflux both in orthostatic and decubitus position. An 8-cm laparoscopic Heller myotomy combined with an anterior 220° Dor fundoplication was performed. Solid diet was introduced on postoperative day 2, and the patient was discharged home the same day. At 17-mo follow-up, he reported no symptoms. Barium swallow was compatible with complete radiologic resolution. Both esophageal manometry and upper endoscopy showed normal findings 9 mo after the operation. CONCLUSION Surgical treatment with Heller myotomy and Dor fundoplication is a potential treatment option for EGJOO refractory to medical treatment

Neoadjuvant multikinase inhibitor in patients with locally advanced unresectable thyroid carcinoma

Background: Papillary thyroid carcinoma (PTC) is the most common and less aggressive thyroid cancer, but some patients may display locally advanced disease. Therapeutic options are limited in these cases, particularly for those patients with unresectable tumors. Neoadjuvant therapy is not part of the recommended work up. Methods: Report a case of an unresectable grossly locally invasive PTC successfully managed with neoadjuvant therapy and provide a systematic review (SR) using the terms “Neoadjuvant therapy” AND “Thyroid carcinoma.” Results: A 32-year-old man with a 7.8 cm (in the largest dimension) PTC was referred to total thyroidectomy, but tumor resection was not feasible due to extensive local invasion (trachea, esophagus, and adjacent structures). Sorafenib, a multikinase inhibitor (MKI), was initiated; a 70% tumor reduction was observed after 6 months, allowing new surgical intervention and complete resection. Radioactive iodine (RAI) was administered as adjuvant therapy, and whole body scan (WBS) shows uptake on thyroid bed. One-year post-surgery the patient is asymptomatic with a status of disease defined as an incomplete biochemical response. The SR retrieved 123 studies on neoadjuvant therapy use in thyroid carcinoma; of them, 6 were extracted: 4 case reports and 2 observational studies. MKIs were used as neoadjuvant therapy in three clinical cases with 70–84% of tumor reduction allowing surgery. Conclusion: Our findings, along with other reports, suggest that MKIs is an effective neoadjuvant therapy and should be considered as a therapeutic strategy for unresectable grossly locally invasive thyroid carcinomas